J0402 HCPCS code: Injection, aripiprazole (abilify asimtufii), 1 mg
J0402 is the HCPCS Level II code for injection, aripiprazole (abilify asimtufii), 1 mg. In 2024 Medicare paid an average of $1.97 per service for J0402 across 11,301 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 960 per day on DME suppliers. In 2024, about 20 clinicians billed Medicare for J0402 for 20 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2024-01-01 |
| Last action effective | 2024-01-01 |
Who bills J0402 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 20 |
| Medicare beneficiaries | 20 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0402, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 11,301 | 20 | $2.48 | $1.97 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 960 | Prescribing Information |
| outpatient hospital claims | 960 | Prescribing Information |
| practitioner claims | 960 | Prescribing Information |
What changed for J0402
- 2024-01-01: J0402 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J0402?
J0402 is the HCPCS Level II code for injection, aripiprazole (abilify asimtufii), 1 mg. Short descriptor: "Inj, abilify asimtufii, 1 mg".
How much does Medicare pay for J0402?
In 2024, the average Medicare payment was $1.97 per service (average allowed $2.48).
Does Medicare cover J0402?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0402 can be billed per day?
960 on DME suppliers; 960 on outpatient hospital claims; 960 on practitioner claims (NCCI medically unlikely edits).
Related J04 codes
- J0400 — Injection, aripiprazole, intramuscular, 0.25 mg
- J0401 — Injection, aripiprazole (abilify maintena), 1 mg
- J0456 — Injection, azithromycin, 500 mg
- J0457 — Injection, aztreonam, 100 mg
- J0458 — Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)
- J0461 — Injection, atropine sulfate, 0.01 mg
- J0462 — Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg
- J0463 — Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg
- J0470 — Injection, dimercaprol, per 100 mg
- J0475 — Injection, baclofen, 10 mg
- J0476 — Injection, baclofen, 50 mcg for intrathecal trial
- J0480 — Injection, basiliximab, 20 mg
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J0402
- Watch J0402 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0402
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.